How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,513.56 | Professional | None | $575.44 | $575.44 | $1,513.56 |
Ambetter Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,318.26 | $1,318.26 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $1,318.26 | Facility | None | $812.83 | $1,318.26 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $3,019.95 | Professional | None | $1,023.29 | $1,288.25 | $3,019.95 |
Medica Setting Facility Modifier None Typical Low $660.69 Median $1,122.02 Typical High $3,890.45 | Facility | None | $660.69 | $1,122.02 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $1,174.90 | Professional | None | $478.63 | $707.95 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,318.26 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $1,737.80 Median $2,884.03 Typical High $3,235.94 | Professional | None | $1,737.80 | $2,884.03 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
United Setting Professional Modifier None Typical Low $371.54 Median $691.83 Typical High $1,000.00 | Professional | None | $371.54 | $691.83 | $1,000.00 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $288.40 Typical High $380.19 | Professional | 52 · Reduced service | $288.40 | $288.40 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $151.36 | Professional | 53 · Discontinued | $114.82 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $114.82 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $75.86 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $75.86 |
Where Nebraska sits
The same service costs 2.6 times more in Hawaii than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Nebraska· 13th of 51
$851
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.